The Children’s Hospital Without Walls
For some pediatric hospitalists, a ferry ride across Lake Champlain is now part of their regular commute. Beginning in 2017, UVM Medical Center established a pediatric hospitalist service at Champlain Valley Physicians Hospital (CVPH) in Plattsburgh, N.Y., on the western shores of Lake Champlain. Since then, four physicians have been recruited to work primarily at CVPH, with 25 percent of their time allocated to service at UVM Children’s Hospital. Six hospitalists based at UVM Children’s Hospital also rotate through shifts in Plattsburgh. The shortest distance between the two cities is a 20-minute ferry ride, so the hospitalists are crossing the lake regularly. Karen Leonard, MD, director of the Division of Pediatric Hospital Medicine, says the goal is integration, with both institutions now members of the UVM Health Network.
“Everyone who works over there works here too, so that we can understand systems between the two hospitals,” she says.
Collaboration advances education, improves care
CVPH hospitalists admit pediatric inpatients, care for all newborns, assist with deliveries, provide consultation in the emergency department, and provide inpatient consultation to subspecialty services. The exchange between Vermont and New York provides opportunities for education in both directions: Plattsburgh-based hospitalists have the chance to work with residents and fellows in Burlington, while Burlington-based hospitalists experience what it’s like to provide care at a community hospital.
The new hospitalists—including Jana Lichtenfeld, MD; Andrea Reed, MD; Stephanie Ryan, MD, MPH; and Benjamin Ittleman, MD—bring fresh enthusiasm and strong credentials to the team. They’re doing important work on a range of initiatives, including spearheading quality improvement projects, developing curricula for residents and medical students, and researching barriers to immunization and other topics.
The new service also offers opportunities for collaboration and growth. UVM’s Clinical Simulation Lab provides leading edge interprofessional training for pediatric hospitalists and nurses. An expansion of telemedicine capabilities— allowing specialists in Burlington to consult on patients in Plattsburgh—may be possible. Also in the works: Adapting some of the quality improvement work already happening at UVM Medical Center to a community hospital setting.
Expanding pediatric care
Patients have responded well to the integration of the two institutions, says Leonard, and community pediatricians as well as nurses at CVPH benefit from the shared services.
“They have a skilled, dedicated group of nurses who have embraced our presence,” says Leonard. “It’s a lovely community to work in.” Lake Champlain and state borders aside, the goal is top notch family-centered care. Lewis First, MD, chief of pediatrics for UVM Children’s Hospital and the Department of Pediatrics, says he is “delighted that we can extend the high-quality, child-friendly pediatric care of the UVM Children’s Hospital to CVPH so we truly become a children’s hospital whose ‘walls’ are those of the Network itself. This will let us make local pediatric care the best it can be.”